• Journal of Oriental Neuropsychiatry
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• v.12 no.1
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• pp.219-229
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• 2001

The brainstem include midbrain, pons & medulla. In acute stage of brainstem infarction, neurologic symptoms may be progressive. So we must pay special attention to Wallenberg's syndrome. In other words, Wallenberg's syndrome is dorsolateral medullary syndrome. A-54-years-old woman was admitted because of vertigo, ataxia & somatic sensory loss of left face and right half-body. Brain MRI showed high SI in T2W, low SI in T1W lesion left medullary infarction. We diagnosed the case as Shin-heo type Oriental medically and prescribed Gihwangemjakamibang. Diabetes mellitus was found out. So We have controlled diabetes mellitus by Occidental medical therapy. In the end, The symptoms of the patient became better. We know that cooperative(oriental & occidental) medical therapy is better than one medical therapy.Here we present one case of Wallenberg's syndrome who was admitted at Kunpo Wonkwang University Hospital Oriental Neuropsychiatry from 14th March to 6th April. 2001.

• Korean Journal of Veterinary Research
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• v.52 no.2
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• pp.83-87
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• 2012

The study of pigs as a human disease model has been conducted in neuroscience. But the morphological development of pig brain by using MRI is rare. The purpose of this study is to determine whether cerebellum maintains consistent proportion to other brain regions in aging. Clinically healthy sixteen micropigs, 1, 2, 4, and 8 months were studied. The micropigs were anesthetized with isoflorane. MRI was acquired using a 0.3T system. To figure out development of ratio that allowed identification of normal cerebellum size, we measured the area of the cerebellum, brainstem, and forebrain from the mid-sagittal brain images on T1W. Mid-sagittal cross-sectional area (CSA) of total brain, forebrain, brainstem, and cerebellum were expressed as absolute values and also as percentages which were compared between the four age groups of micropigs for the purpose to define the effect of age on brain morphometry. It was found that there was not a significant difference in the percentage of the brain occupied by an individual region between groups although the absolute CSA differed significantly among age groups. There was no effect of age on the ratio between the cerebellum and total brain in 4 age groups. The normal size of cerebellum changes during brain development maintained a consistent ratio to other brain regions in normal micropigs. The ratio of CSA quantified on the mid-sagittal MR images offers a suitable method to detect presence of cerebellar anomalies in micropigs.

• Korean Journal of Clinical Laboratory Science
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• v.43 no.1
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• pp.19-25
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• 2011

The purpose of this study was to analyse brainstem auditory evoked potentials (BAEP) wave change data during microvascular decompression (MVD). The nerve function of Cranial Nerve VIII is at risk during MVD. Intraoperative monitoring of BAEP can be a useful tool to decrease the danger of hearing loss. Between January and December 2009, 242 patients had MVD for hemifacial spasm (HFS) and trigeminal neuralgia (TN). Among intraoperative BAEP changes, amplitude of V-V' was the most frequently observed during cerebellar retraction and decompression step of the MVD procedure. 138 patients (57%) had no BAEP change while 104 patients (42.98%) had BAEP change. 69 patients (28.5%) had Type A-I, 16 patients (6.6%) had Type A-II, 5 patients (2.1%) had Type B, and 13 patients (5.37%) had Type C. MVD is a surgical procedure to relieve the symptoms (e.g. pain, muscle twitching) caused by compression of a nerve by an artery or vein. During BAEP intraoperative monitoring, the surgical step is important in interpreting the changes of wave V. Several potential mechanisms of injury may affect the cochlear nerve, and complete loss of BAEP is often associated with postoperative hearing loss. Intraoperative BAEP monitoring may provide an early warning of hearing disturbance after MVD.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.34 no.3
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• pp.80-91
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• 2021

Objective : The purpose of this study is to discriminate the vestibular schwannoma misdiagnosed as Idiopathic Sudden Sensorineural Hearing Loss. Methods : A 46-year-old female patient who was suffering left sudden sensorineural hearing loss(SSNHL), visited after diagnosed as Idiopathic SSNHL by previous hospital. For diagnosing the vestibular schwannoma, we conducted the Puretone audiometry, auditory brainstem response threshold test and magnetic resonance imaging(MRI) for temporal bone with enhancement. Result : Auditory Brainstem Response threshold test was abnormal and in enhanced MRI, the vestibular schwannoma in left side was detected. The patient was discharged from the hospital for tertiary hospital care. Conclusions : When the patient with SSNHL visits a hospital even if after diagnosed as Idiopathic SSNHL by previous hospital, a doctor should keep in mind the possibility of vestibular schwannoma.

• Investigative Magnetic Resonance Imaging
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• v.25 no.2
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• pp.101-108
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• 2021

Purpose: To identify characteristic magnetic resonance imaging (MRI) features to differentiate between Krabbe disease and metachromatic leukodystrophy (MLD) in young children. Materials and Methods: We collected all confirmed cases of Krabbe disease and MLD between October 2004 and September 2020 at Seoul National University Children's Hospital. Patients with initial MRI available were included. Their initial MRIs were retrospectively reviewed for the following: 1) presence of white matter signal abnormality involving the periventricular and deep white matter, subcortical white matter, internal capsule, brainstem, and cerebellum; 2) presence of volume decrease and signal alteration in the corpus callosum and thalamus; 3) presence of the tigroid sign; 4) presence of optic nerve hypertrophy; and 5) presence of enhancement or diffusion restriction. Results: Eleven children with Krabbe disease and 12 children with MLD were included in this study. There was no significant difference in age or symptoms at onset. Periventricular and deep white matter signal alterations sparing the subcortical white matter were present in almost all patients of the two groups. More patients with Krabbe disease had T2 hyperintensities in the internal capsule and brainstem than patients with MLDs. In contrast, more patients with MLD had T2 hyperintensities in the splenium and genu of the corpus callosum. No patient with Krabbe disease showed T2 hyperintensity in the corpus callosal genu. A decrease in volume in the corpus callosum and thalamus was more frequently observed in patients with Krabbe disease than in those with MLD. Other MRI findings including the tigroid sign and optic nerve hypertrophy were not significantly different between the two groups. Conclusion: Signal abnormalities in the internal capsule and brainstem, decreased thalamic volume, decreased splenial volume accompanied by signal changes, and absence of signal changes in the callosal genu portion were MRI findings suggestive of Krabbe disease rather than MLD based on initial MRI. Other MRI findings such as the tigroid sign could not help differentiate between these two diseases.

• Journal of Audiology & Otology
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• v.25 no.4
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• pp.199-208
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• 2021

Background and Objectives: No known studies have investigated the influence of stimulus polarity on the Auditory Brainstem Response (ABR) elicited from level-specific (LS) chirp. This study is important as it provides a better understanding of the stimulus polarity selection for ABR elicited from LS chirp stimulus. We explored the influence of stimulus polarity on the ABR from LS chirp compared to the ABR from click at 80 dBnHL in normal-hearing adults. Subjects and Methods: Nineteen adults with normal hearing participated. The ABRs were acquired using click and LS chirp stimuli using three stimulus polarities (rarefaction, condensation, and alternating) at 80 dBnHL. The ABRs were tested only on the right ear at a stimulus rate of 33.33 Hz. The ABR test was stopped when the recording reached the residual noise level of 0.04 μV. The ABRs amplitudes, absolute latencies, inter-peak latencies (IPLs), and the recorded number of averages were statistically compared among ABRs at different stimulus polarities and stimuli combinations. Results: Rarefaction polarity had the largest ABR amplitudes and SNRs compared with other stimulus polarities in both stimuli. There were marginal differences in the absolute latencies and IPLs among stimulus polarities. No significant difference in the number of averages required to reach the stopping criteria was found. Conclusions: Stimulus polarities have a significant influence on the ABR to LS chirp. Rarefaction polarity is recommended for clinical use because of its larger ABR peak I, III, and V amplitudes than those of the other stimulus polarities.

• Journal of Audiology & Otology
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• v.25 no.1
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• pp.14-21
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• 2021

Background and Objectives: There is growing interest in the use of the Level-specific (LS) CE-Chirp^® stimulus in auditory brainstem response (ABR) due to its ability to produce prominent ABR waves with robust amplitudes. There are no known studies that investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus. The present study aims to investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus and compare its reliability with the ABR to standard click stimulus at multiple intensity levels in normal-hearing adults. Subjects and Methods: Eleven normal-hearing adults participated. The ABR test was repeated twice in the same clinical session and conducted again in another session. The ABR was acquired using both the click and LS CE-Chirp^® stimuli at 4 presentation levels (80, 60, 40, and 20 dBnHL). Only the right ear was tested using the ipsilateral electrode montage. The reliability of the ABR findings (amplitudes and latencies) to the click and LS CE-Chirp^® stimuli within the same clinical session and between the two clinical sessions was calculated using an intra-class correlation coefficient analysis (ICC). Results: The results showed a significant correlation of the ABR findings (amplitude and latencies) to both stimuli within the same session and between the clinical sessions. The ICC values ranged from moderate to excellent. Conclusions: The ABR results from both the LS CE-Chirp^® and click stimuli were consistent and reliable over the two clinical sessions suggesting that both stimuli can be used for neurological diagnoses with the same reliability.

• Korean Journal of Audiology
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• v.25 no.1
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• pp.14-21
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• 2021

Background and Objectives: There is growing interest in the use of the Level-specific (LS) CE-Chirp^® stimulus in auditory brainstem response (ABR) due to its ability to produce prominent ABR waves with robust amplitudes. There are no known studies that investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus. The present study aims to investigate the test-retest reliability of the ABR to the LS CE-Chirp^® stimulus and compare its reliability with the ABR to standard click stimulus at multiple intensity levels in normal-hearing adults. Subjects and Methods: Eleven normal-hearing adults participated. The ABR test was repeated twice in the same clinical session and conducted again in another session. The ABR was acquired using both the click and LS CE-Chirp^® stimuli at 4 presentation levels (80, 60, 40, and 20 dBnHL). Only the right ear was tested using the ipsilateral electrode montage. The reliability of the ABR findings (amplitudes and latencies) to the click and LS CE-Chirp^® stimuli within the same clinical session and between the two clinical sessions was calculated using an intra-class correlation coefficient analysis (ICC). Results: The results showed a significant correlation of the ABR findings (amplitude and latencies) to both stimuli within the same session and between the clinical sessions. The ICC values ranged from moderate to excellent. Conclusions: The ABR results from both the LS CE-Chirp^® and click stimuli were consistent and reliable over the two clinical sessions suggesting that both stimuli can be used for neurological diagnoses with the same reliability.

• Korean Journal of Audiology
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• v.25 no.4
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• pp.199-208
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• 2021

Background and Objectives: No known studies have investigated the influence of stimulus polarity on the Auditory Brainstem Response (ABR) elicited from level-specific (LS) chirp. This study is important as it provides a better understanding of the stimulus polarity selection for ABR elicited from LS chirp stimulus. We explored the influence of stimulus polarity on the ABR from LS chirp compared to the ABR from click at 80 dBnHL in normal-hearing adults. Subjects and Methods: Nineteen adults with normal hearing participated. The ABRs were acquired using click and LS chirp stimuli using three stimulus polarities (rarefaction, condensation, and alternating) at 80 dBnHL. The ABRs were tested only on the right ear at a stimulus rate of 33.33 Hz. The ABR test was stopped when the recording reached the residual noise level of 0.04 μV. The ABRs amplitudes, absolute latencies, inter-peak latencies (IPLs), and the recorded number of averages were statistically compared among ABRs at different stimulus polarities and stimuli combinations. Results: Rarefaction polarity had the largest ABR amplitudes and SNRs compared with other stimulus polarities in both stimuli. There were marginal differences in the absolute latencies and IPLs among stimulus polarities. No significant difference in the number of averages required to reach the stopping criteria was found. Conclusions: Stimulus polarities have a significant influence on the ABR to LS chirp. Rarefaction polarity is recommended for clinical use because of its larger ABR peak I, III, and V amplitudes than those of the other stimulus polarities.

• Journal of the Institute of Electronics Engineers of Korea SC
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• v.44 no.1
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• pp.100-107
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• 2007

AABR(automated auditory brainstem response) test is used for the screening purpose of hearing ability of neonates. In this paper, algorithm using Rolle's theorem is suggested for automatic detection of the ensemble averaged ABR waveform. The ABR waveforms were recorded from 55 normal-hearing ears of neonates at screening levels varying from 30 to 60 dBnHL. Recorded signals were analyzed by expert audiologist and by the proposed algorithm. The results showed that the proposed algorithm correctly identified latencies of the major ABR waves (III, V) with latent difference below 0.2 ms. No significant differences were found between the two methods. We also analyzed the ABR signals using derivative algorithm and compared the results with proposed algorithm. The number of detected candidate waves using the proposed algorithm was 47 % less than that of the existing one. The proposed method had lower relative errors (0.01 % error at 60dBnHL) compared to the existing one. By using proposed algorithm, clinicians can detect and label waves III and V more objectively and quantitatively than the manual detection method.